CC EXAM Flashcards
A hazard symbol with three circles arranges in a triangle connected by a circle in the middle.
A. Radioactive hazard
B. Health Hazard
C. Flammable Hazard
D. Biohazard
Biohazard
What is the conversion factor used in Glucose from mg/dL to mmol/L.
A. 0.0555
B. 0.01113
C. 10
D. 2.14
0.0555
It is the unit used for the amount of substance
A. m
B. kg
C. s
D. mol
mol
What is the meaning of “R” in RACE in Fire Safety
A. Run
B. Recess
C. Rescue
D. Retrieve
Rescue
RESCUE
ALARM, CONTAIN,
EXTINGUISH
PULL,
AIM,
SQUEEZE,
SWEEP
A solution that has a transmittance of 1.0%T
would have an absorbance of:
A. 1.0
B. 2.0
C. 1%
D. 99%
2.0
*Beer’s Law states that the concentration of a chemical solution is directly proportional to its absorption of light. Transmittance is inversely
proportional to the absorbance.
Absorbance = 2–log (%T)
Absorbance = 2–log(1)
Absorbance = 2–0
Absorbance = 2
It isolates specific or individual wavelength of light.
A. Light source
B. Entrance slit
C. Monochromator
D. Exit slit
Monochromator
- Light source: Provides polychromatic light
- Entrance Slit: Minimizes unwanted or stray light
- Monochromator: It isolates specific or individual wavelength of light.
- Exit slit: Control the width of light beam (bandpass)
- Cuvette: Holds the solution to be measured
- Photodetector: Detects and converts transmitted light into photoelectric energy.
- Meter or Read-out device: Displays output of the detection system
Control values that are far from the main set of values.
A. Outliers
B. Trend
C. Shift
D. None of the Above
Outliers
*
Trend – Progressive drift of values to ONE SIDE of the mean
Shift- Abrupt change in the mean
Outliers- Control values that are far from the main set of values
Which of the following are the examples of
RANDOM ERROR:
I. Variation in handling techniques
II. Variation in operators
III. Temperature of analyzer
IV. Instability of instrument
A. I and II only
B. I, II and III only
C. I and III only
D. All of the above
All of the above
*
Random error – error that varies from one measurement to the next; occurs by CHANCE and has no means of predicting it.
Systematic error- error that influences observations consistently in ONE DIRECTION
It is the type of solution that contains several analytes with known concentration.
A. Standard
B. Control
C. Blank
D. None of the above
Control
*
Standard – it contains only 1 analyte with known concentration. Calibration and Reference
Control- it contains several analytes with known concentration. Ensures correct results
It is used to check the accuracy of test performed.
A. T test
B. F test
C. Variance
D. Delta check
T test
SPF – SD, Precision, F-test
MAT- Mean, Accuracy, T-test
Variance- measures the average degree to which each point differs from the mean.
Delta check- is a process to detect discrepancies in patient test results prior to reporting by
comparing current patient values to previous ones.
What is the confirmatory method for measuring drug of abuse
A. TLC
B. GC-MS
C. EMIT
D. HPLC
GC-MS
The ion selective membrane used to measure potassium is made of:
A. Polyvinyl chloride dioctyl phenyl phosphate ion exchanger
B. Valinomycin gel
C. High-borosilicate glass membrane
D. Calomel
Valinomycin gel
Which electrolyte measurement is least affected by hemolysis?
A. Phosphorus
B. Calcium
C. Potassium
D. Magnesium
Calcium
Mnemonics by Sir Jed:
* Na K
* Ca Fe
* PISO - Potassium Inside, Sodium Outside
* PICO- Phosphate Inside, Chloride Outside
Which of the following conditions involving electrolytes is described correctly.
A. Hypercalcemia may be induced by low serum magnesium
B. Potassium levels are slightly higher in heparinized plasma than in serum
C. Pseudohyponatremia occurs only when undiluted samples are measured
D. Hypoalbuminemia causes low total calcium but does not affect ionized calcium
Hypoalbuminemia causes low total calcium but does not affect ionized calcium
*When serum albumin is low, the equilibrium between bound and Cai is shifted, producing
increased Cai . This inhibits release of PTH by negative feedback until the Cai level returns to normal. Potassium is released from platelets and
leukocytes during coagulation, causing serum levels to be higher than plasma.
Pseudohyponatremia is a measurement error caused by diluting samples containing excessive fat or protein. The colloids displace plasma water, resulting in less electrolytes being delivered into the diluent. Only ion-selective electrodes that measure whole blood or undiluted serum are unaffected. Magnesium is needed for release of PTH, and PTH caused released of calcium and magnesium from bone. Therefore, hypocalcemia can be associated with either magnesium deficiency or magnesium excess.
Which electrolyte has an inverse relationship with bicarbonate in order to maintain electric neutrality.
A. Sodium
B. Phosphate
C. Chloride
D. Potassium
Chloride
Functions of Chloride: Maintenance of electrical neutrality in the body, Helps maintain serum osmolality & water balance, has an inverse
relationship with bicarbonate (it exchanges with Bicarbonate (HCO3) when it leaves the cell).
To maintain electrical neutrality a negative ion has to move into the cell OR a positive ion has to move out with the bicarbonate ion.
An analytical test using a device, tool or equipment with a different chemical or physical
principle that is more specific which will validate the result from the initial tests.
A. initial and confirmatory test
B. screening test
C. screening and initial test
D. confirmatory test
confirmatory test
- Screening: High degree of
sensitivity; Prone to false negatives - Confirmatory: High degree of
specificity
Reference method for Calcium:
A. Nephelometry
B. Atomic Absorption Spectrophotometry
C. Turbidimetry
D. Flame Emission Photometry
Atomic Absorption Spectrophotometry
AAS- it is used for measurement of unexcited trace metals (calcium and magnesium)
FEP- it is used in the measurement of the excited ions (sodium and potassium)
Turbidimetry- It determines the amount of light blocked by a particulate matter in a turbid
solution. It is best in protein measurements, detecting microbial growth in broth culture, antimicrobial test (broth method) and in detecting clot formation.
Nephelometry- It determines the amount of light scattered by a particulate matter suspended in a turbid solution. It is used for measuring the amount of antigen-antibody complexes (proteins)
NRL for drug testing
A. EAMC
B. NKTI
C. RITM
D. SACCL
EAMC
A trough blood sample for routine therapeutic drug monitoring is usually obtained:
A. Just before the next dose.
B. Just after a dose is administered.
C. At the calculated peak time after a dose
D. One half-life after a dose is administered
Just before the next dose.
Trough concentration- it is a lowest concentration of a drug obtained in the dosing
interval. Obtained just before the next dose
Peak concentration- it is a lowest concentration of a drug obtained in the dosing interval. Obtained after 1 hour of administration except “digoxin” 8 hours.
Screening test, except:
A. EMIT
B. ELISA
C. TLC
D. GC-MS
GC-MS
GC-MS- it is the GOLD STANDARD in drug testing
for identification and quantitation of drugs in body fluids.
TLC- it is a semiquantitative drug screening test.
EMIT- it is a screening test for therapeutic and prohibited drugs.
ELISA- screening test for HIV
It is the ability of the analytical method to measure the smallest amount of analyte being detected.
A. Practicability
B. Diagnostic Sensitivity
C. Analytical Sensitivity
D. Analytical Specificity
Analytical Sensitivity
Sensitivity- it is the ability of an analytical method to measure the smallest concentration
of the analyte of interest
Specificity- it is the ability of an analytical method to determine only the analyte of interest.
Practicability- it is the degree by which a method is easily repeated
Diagnostic specificity – it is the ability of the analytical method to detect the proportion of individuals without the disease.
Diagnostic sensitivity – It is the ability of the analytical method to detect the proportion of individuals with the disease.
Red color in biosafety means:
A. Stop
B. Be careful
C. Caution
D. Radiation hazard
Stop
What should be done first in a blood spill?
A. Add freshly prepared 10% chlorine solution
B. Use disposable paper towels to absorb
C. Let it dry then wash with water
D. Wash with warm water
Use disposable paper towels to absorb
*First, use disposable paper towels to absorb then add freshly prepared 10% chlorine solution.
Best advice to give to an elderly woman that is asked to fast for a test
A. Drink water
B. Exercise lightly
C. She can eat small meals
D. Breath regularly
Drink water
Fasting
-Fasting requirement is between 8 to 12 hours.
-TAGS – 10 to 12 hours
-OGTT- 8 to 14 hours is acceptable
-Atleast 8 hours before the test no excersie.
It is known to give the best visualization of QC data
A. LJ chart
B. Youden twin plot
C. Gaussian curve
D. CUSUM
LJ chart
Shewhart Levey Jennings Chart (aka. DOT CHART)
- It is the most widely used QC chart in clinical laboratory
- It easily identifies random and systematic error
- It is a graphic representation of the acceptable limits of variation in the results of an analytical method.
- It is best for internal laboratory quality control Youden twin plot
-It is used to compare results obtained on a high and low control serum from different
laboratories
-It is best for calibration and reagent preparation error. It detects random and systematic error Gaussian Curve
-It occurs when the data set can be accurately described by the SD and mean. It detects random
and systematic error
-It focusses on the distribution or errors from the analytical method rather than the values from healthy or patient population. CUSUM (aka. SIDEWAY)
- It calculates the difference between QC results and the target means
-Common method: V-mask
-This plot will give the earliest indication of systematic errors (trend) and can be used with
the 13s
Most popular and versatile automated analyzer
A. Continuous Flow Analyzer
B. Centrifugal Analyzer
C. Discrete Analyzer
D. Technicon Analyzer
Discrete Analyzer
Continuous Flow
-Sample flow through a common vessel or pathway. Liquids are pumped through a system of continuous tubing. Air bubbles serve as separating and
cleaning media.
Discrete Analysis
- Each sample-reagent mixture is handled separately in its own reaction vessel. Employs a variety of syringe pipettes to aspirate and dispense sample 2-6uL and reagents. Capable of running multiple test one sample at a time. Allows STAT samples to be easily accessed
Centrifugal Analysis
- Uses the force generated by
centrifugation to transfer specimens and reagents. Uses acceleration and deceleration of rotor to transfer the reagents and sample. For mixing centrifugal force (rotor) is utilized or bubbling of air. Advantage: Batch analysis
True for Delta Bilirubin
A. It is unconjugated bilirubin tightly bound to albumin
B. It has a longer half-life than other form of bilirubin
C. It is calculated on neonatal patients
D. It does not react with diazo reagents
It has a longer half-life than other form of bilirubin
Delta Bilirubin
* It is conjugated bilirubin tightly bound to albumin.
* It has a longer half-life than other forms of bilirubin
* It is formed due to prolonged elevation of conjugated bilirubin in biliary obstruction
* It reacts with diazo reagent in the direct bilirubin assay.
Detects the frequency of erroneous results
A. Pareto chart
B. Six Sigma
C. ISO 9001:2015
D. Lean System
Six Sigma
Six Sigma – It is a performance improvement program in which the goal is to improve the process by eliminating variations or errors. It is a tool that can be used to reduce laboratory
errors, increase productivity, and improve quality in the clinical laboratory.
Lean system- It is a system for reducing waste (non-valued activities) especially in production or manufacturing processes.
Six sigma except:
A. Improving accuracy of results
B. Identifying and solving erroneous results
C. Reducing TAT
D. Replacing erring MT staff
Reducing TAT
Indicators of the Improvement program:
-Improved performance
-Improved quality
-Improved bottom line
-Improved customer satisfaction
-Improved employee satisfaction
It is the most commonly used method for measuring the changes in colligative properties
of a solution.
A. Freezing point depression
B. Boiling point
C. Osmotic Pressure
D. Vapor pressure
Freezing point depression
What is the ACCEPTABLE SD range?
A. +/- 1SD
B. +/ - 2SD
C. +/- 3SD
D. +/-4SD
+/ - 2SD
-The acceptable reference limit is set at +/- 2SD
-Some laboratories use the 2s as a warning limit and 3s as an error limit.
-When the values exceed 2s = values are dispersed. If the values are close to each other the SD is less than 2s.
-1s to +1s 68.27%
-2s to +2s 95.45% (BASIS)
-3s to +3s 99.73%
Which of the following is not included in proficiency testing?
A. Analysis of the unknown samples should be completed and reported within 48 hours
B. Unknown samples must be tested using the same reagents and equipment for actual patient specimens
C. Unknown samples should be processed and treated like a patient
D. It allows each participating laboratory to compare and evaluate test results with those laboratories that use the methods after the testing period.
Analysis of the unknown samples should be completed and reported within 48 hours
External QC – it involves proficiency testing programs that periodically provide samples of unknown concentration to participating clinical laboratories. Unknown samples should be completed within the usual time as for the
routine samples. Unknown samples should be processed and treated like a patient specimen to determine the true essence of accuracy.
What is the ideal concentration of the buffer in serum protein electrophoresis.
A. pH 5.2
B. pH 6.5
C. pH 7.4
D. pH 8.6
pH 8.6
*Electrophoresis- Migration of charged particles in an electric field. Buffer: Barbital (pH 8.6) aka. Veronal
In electrochemistry, it is a type of pH electrode with a sodium bicarbonate buffer utilized in the measurement of carbon dioxide.
A. Clark
B. Valinomycin
C. Calomel
D. Severinghaus
Severinghaus
Severinghaus – pCo2 Electrode
Valinomycin gel- potassium
Calomel electrode- chloride
Clark- Po2
Intense fist-clenching results in sudden high concentration of this metabolic product.
A. Creatinine
B. Ammonia
C. Lactate
D. Pyruvate
Lactate
Tourniquet Application
-For accurate measurement of lactate, tourniquet should not be applied, and the patient should not clench his fist at the time of blood draw.
A blood sample for this assay should not be drawn after physical exercise otherwise the plasma concentration may be falsely decreased.
A. Somatotropin
B. Ammonia
C. Glucose
D. Lactate
Glucose
Glucose is utilized by the body therefore it decreases. Since glucose is released, the body will compensate, it will release cortisol (hyperglycemic hormone). Somatotropin is also known as growth hormone which is a hyperglycemic hormone that promotes glycolysis and glycogenolysis. Muscle is rich in lactate (lactate dehydrogenase) therefore it increases.
This tube is used in the analysis of glycosylated hemoglobin.
A. Royal blue top
B. Orange top
C. White pearl top
D. Purple top
Purple top
Royal blue- Trace elements toxicology nutritional studies and TDM
Orange- General chemistry
White pearl-
molecular diagnostics
Purple- hematology and glycated hemoglobin
The following statements are true regarding blood collection except:
A. When blood is put into a vacuum tube with a narrow needle, red blood cells are
destroyed.
B. If blood pressure cuff is used as a tourniquet, it is inflated to 60mmHg
C. Blood sample collected in an additive tube can be transferred to another tube of the same kind.
D. The gauge of the needle is inversely related to the size of the needle.
Blood sample collected in an additive tube can be transferred to another tube of the same kind.
A 42 year old female patient with loss of consciousness was presented to the emergency
room. She has diabetes mellitus and is currently under insulin therapy. She was about to report to work when she suddenly lost her balance and fell on the floor. Which of the following tests should be prioritized immediately to assess her condition?
A. Glycosylated hemoglobin
B. Random blood sugar
C. 2-hour OGTT
D. Fasting plasma glucose
Random blood sugar
*RBS it is requested during insulin shock and hyperglycemic ketonic coma.
